Mom refuses any home heath care providers despite her significant lack of independence.

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This is a common problem. I work at a home care agency, and it's something I encounter often when I discuss the benefits of having home care services. Its a service that benefits the family members. My suggestion is to continue being persistent because it will help the both of you in the long run.

Me and my siblings are experiencing this too with Dad who is 93. He does not want to pay for any in home help. My Mom who is 88 and barely able to walk with a walker and has pain from spinal stenosis...needs the help. But Dad has always been extremely controlling and very narcissist in that he thinks of no one else but himself. We, the children, went ahead and got the in home help but when Dad got the bill he told the helper not to come back. They can afford the help...in fact...they need to spend down some of their money so they can be eligible for additional assistance but can't make Dad understand this. Of course, me and my siblings have to do everything, Dr appts, groceries, house cleaning, yard work, etc. My Dad cannot drive anymore. So we are very upset with him and I'm not taking him to any more Dr appts. I will take my Mom. Or I'm charging per hour for the help I'm giving.

Once I realized that my loved one with stage 6 Alzheimer's was never going to understand or agree to anything regarding her care, I switched gears and began making up fantastic stories about how the house needed some sort of urgent repair. I'd say, for example, "The plumber is here to fix a leak and this is his wife. She's going to make him his lunch while I go to the store for parts." Of course, the lady was the caregiver and she was there to make my loved one her lunch. Sometimes it was the roofer, or the gardener or the carpet guy. This type of deception worked well to get a relief caretaker in the house when nothing else would. She seemed to understand that leaks had to be fixed. She didn't feel threatened because it wasn't about her.

I used another ruse to get her to stay one afternoon a week at an Alzheimer's day club by telling her I worked in the front office. I'd wave goodbye as I told her I had to go check in with my boss next door. She was fine thinking I was in the room next door. The folks at the center knew about the deception and they were helpful to play along.

My mother-in-law lives with us and 24/7 caretaking is exhausting. I used to feel guilty about these deceptions, but they are the only way I can gain her cooperation to get a few breaks here and there.

Well I tried using the 'we need a housekeeper to come in sometimes' route.
She said ' I don't want them to see the dirty house.'
'Well, that's why we need her to come.'
'I would be too embarrassed.'
'They've seen dirty houses before.'
'Not like THIS one!'
So that's where we are now - don't know if I will make progress or not.... ( she won't go to daycare either, with the 'loud old people.')
Sigh.

I'm sorry, that sounds like a really tough place to be. It's hard for people to admit they need help as they get older, especially if there are underling health issues like dementia or memory loss. I'm glad you and your sister are aware that she needs help, that's always the first step. I like the suggestion from Sunnygirl1 that you could try introducing the home health care person as a friend instead of a professional there to help her. I would recommend consulting with a doctor about her memory issues, if you haven't already. Hopefully the home nurse will work out but if you ever need other options, there is always assisted living. Assisted living communities are great at providing special memory care to patients suffering from problems like dementia or memory loss.

I agree with what people said about an "alternate explanation. " Tell her it is someone to help your sister, the dogs, whatever helps her accept a new person there. And you'll eventually have to tell her again...and again...and again (if you don't already have to). We also take my mother to adult day care two days a week, but we can't tell her it's that or she will refuse to get out of bed. She usually does WAY better with my husband dropping her off than me (she feels like she can argue with me, but not him). He tells her she's going to memory class.

Oh, and the cereal in the dog dish...? That made me laugh. My mom has cooked the cat food before, so just be glad it was human food going in the dog dish, and not pet food going into the human dishes! ;)

You live far away, Momsgoto. It is silly for you to go clean her house when it is easy to find competent house cleaners locally. Paying her bills might be something one of you can do remotely, on a computer, so that might be something sensible to agree to.

Meals on wheels might be a good way for Mother to get a nice hot meal once a day. (My mother loved this. And when asked about it she always mentioned the dessert first: Oh yes, the meal was good today. The apple crisp was really nice!)

Don't be blackmailed by your mother. Help her in ways that strengthen her independence for as long as possible. And why should she want to pay for help if she can bully her kids into providing that help for free?

"Oh Mom, I could not possibly prepare all your meals! But I could arrange for Meals on Wheels, and bring you a couple of homemade meals for the freezer when I come to visit." "I'm sorry you don't want to try Meals on Wheels, Mom. But I still cannot prepare all your meals. Perhaps you can locate a restaurant that delivers. Or buy prepared meals in the deli department of your grocery store."

This would be especially effective if you and your sibs are on the same page. "Oh, I couldn't possibly do that, Mom. But I could arrange for someone else to do it for you."

As Ann Landers used to say, you can't be a doormat unless you lie down. Stand up for yourself.

Momsgoto - my In-Laws sound like your mom. We live 1000 miles away, but my brother in law and his wife (saint) live 45 miles away. They are expected to come and shovel snow, clean house, help drive to doctor appointments, clean gutters - anything and everything that my healthy in-laws no longer can or WANT to do. My in-laws enjoy telling them what to do and having it done - bossy. Finally my BIL/SIL said "no more" and only come by once every 2 weeks and only do a couple of urgent chores. My inlaws will not hire anyone and complain loudly that their children refuse to help and blamed all of us when FIL got on a ladder and fell. Sometimes it is a no-win. We agreed that someone would always be angry - either my BIL/SIL for caving yet again for a huge list of demands or my FIL/MIL for not getting their way. While my BIL/SIL wanted to hear "you do so much, thank you, we need to hire help to take the load off you", it would never happen, and the load would just get bigger as my IL's lived "independently" So BIL/SIL decided to take their life back. Sometimes our elders are just so damn stubborn and selfish.

I have this problem too. My mother is not that far gone but she refuses help because she doesnt want to pay for it. She wants her children to come and clean her house, cook for her, take care of her personal care and pay her bills. She doesn't want anyone to come to her house except her family. She lives far away from all of us and will not move. There is nothing anyone could say that would soften her position. So that would not work with my mother.

This is SO common and so sad! A person with dementia usually cannot be left alone for more than brief periods, and sometimes not even that. And some people with dementia refuse to have any non-relative "helpers" around. What a frustrating situation!

Mother has a table-pounding, shouting hissy fit. Not pleasant. But what if you go ahead with bringing in some help anyway? She'll probably have another fit. But would that escalate into violence? Would mother attack the helper? If she pounded and shouted and she were ignored, what would happen?

I like Staaarr's suggestion of an alternate explanation of what the helper is doing there. She's there to water the plants or feed the dogs or because she is a friend of sister's who needs some income. Or maybe she wants lessons from your mother on making Mom's famous dumplings. Or she is there to learn to knit or to teach knitting. Or she is there to help Mom organize and label that huge box of photographs sitting in guest room closet. Anything that Mom might accept.

My husband was not pleased when I hired a handyman to do chores he used to handle. I kept assuring him that since he was retired it was time for him to take it easier. This mollified him some.

My husband accepted that he had dementia, and that made things much easier for me. But he often didn't agree about his impairments. "I can stay home alone! I don't need a babysitter." And I would reply, "Yes, I am sure you can, most of the time. But we never know when Lewy (what we called his Lewy Body Dementia) might mess you up and that one time you'd need help. Please accept this for my sake. I will worry the whole time I am away otherwise. I do a lot for you. Could you do this for me?" From what you say about your mother, that probably won't work, but perhaps you can think up a variation on it and might be applicable to her.

My heart goes out to you and your sister. You are doing your best and thinking only of your mother's best interests, but it is very hard when you get resistance from her!

If you try various approaches, let us know how they work out. This is a very common problem, and we learn from each other.

You could try getting help in there and say it is for someone to help with the dogs. Maybe she would accept that your sister wants someone to help with the dogs when she isn't around. Good luck!

Some other ideas:
If you have a good relationship with her doctor you might want to describe what is happening and get her to tell mom that she can not stay alone, that way you would be following "doctor's orders" when you bring in helpers.

If there is a senior daycare in her area she may enjoy getting out for the day. If she resists the idea I read one comment where they had convinced their loved one that they were one of the volunteers there ;)

Are you the Durable POA and health care POA? People with dementia are not able to make decisions for themselves indefinitely. It's like allowing a toddler to run into the highway because they feel like it. Someone needs to take charge and ensure that she's protected. Based on what you've described, I'd not leave her at home alone at all. I'd figure a way to get her to accept the outside help. You can be creative. Some people introduce the helper as a friend who needs some extra money, someone to do light housework who just chats with her, etc. I'd start with someone who might be able to build a rapport with her, so she sees her as a friend, guest, and not a caretaker, though would be what she is.